ABSTRACT
We have investigated the usefulness of ribotyping for the differentiation of aeromonads isolated from five patients with gastroenteritis and from the source water, treatment plant, and distribution system of a small public water supply. Aeromonas hydrophila and Aeromonas caviae were isolated from fecal specimens preserved in Cary-Blair transport medium by using blood ampicillin agar or alkaline peptone water (pH 8.4) subcultured to blood ampicillin agar plates. A. hydrophila, Aeromonas sobria, and A. caviae were isolated from duplicate 100-ml water samples by the membrane filter technique by using ampicillin dextrin agar for quantitative determination of growth and alkaline peptone water enrichment for detection of the presence or absence of aeromonads below the detection limit of the membrane filter method. In addition, free chlorine residuals and pH values were determined for all water samples and heterotrophic plate counts and total and fecal coliform analyses were performed on them. Ribotyping patterns of aeromonads recovered from well 1, detention basin, sand filter, softener, and distribution samples were compared with those of the five clinical isolates. All patient strains were unique; however, identical ribotypes of A. hydrophila and A. sobria isolated from multiple sites in the water system indicated colonization of a well, sand filters, and the softener, with the potential for sporadic contamination of distribution water. Plant operational deficiencies were noted and corrected. Ribotyping can effectively differentiate otherwise indistinguishable strains of bacteria, thus providing a powerful tool for investigation of waterborne diseases and bacteriological problems within water treatment plants and distribution systems.
Subject(s)
Aeromonas/classification , Bacterial Typing Techniques , Aeromonas/genetics , Aeromonas/isolation & purification , DNA, Bacterial/genetics , DNA, Ribosomal/genetics , Gastroenteritis/microbiology , Gram-Negative Bacterial Infections/microbiology , Humans , Infant , Male , Nucleic Acid Hybridization , Species Specificity , Water Microbiology , Water SupplyABSTRACT
Home enteral nutrition support is a rapidly expanding area providing new challenges for the clinical dietitian. It begins with identification of appropriate candidates based on their physical condition, home environment, and goals of therapy. A thorough nutrition assessment is performed to determine macronutrient and micronutrient needs. Considerations for formula selection include the form and source of nutrients, cost, and goals of therapy. Administration may be by a bolus, intermittent gravity drip, continuous infusion, or cyclic infusion method. Selection of an appropriate access route should consider the length of therapy, medical condition, pathology of the gastrointestinal tract, and the infusion method. Discharge teaching should stress maintenance of the patency and tube position, accurate formula delivery, and proper use of equipment and supplies. Issues involving reimbursement and financial responsibility should be addressed before the home therapy is initiated. Home patients should be monitored and reassessed regularly to update the plan of care and goals of therapy. Vendors should be selected on the basis of their capability to meet the patient's needs. If all phases are implemented, home enteral nutrition is a safe and acceptable means of nutrient delivery.
Subject(s)
Enteral Nutrition/methods , Home Nursing , Diarrhea/etiology , Enteral Nutrition/adverse effects , Enteral Nutrition/economics , Humans , Nutritional Status , Patient Discharge , Pneumonia, Aspiration/etiologyABSTRACT
Thirty-nine cancer patients (Ca) and 37 age-and sex-matched healthy controls (Co) evaluated 11 commercially available enteral supplements using a modified wine-tasting scale. The cancer patients were 19 males with lung cancer and 20 females with breast cancer, and their controls consisted of 17 males and 20 females, respectively. Mean evaluation scores for the individual supplements revealed no significant differences (NS) between lung cancer patients and controls. Ensure Plus (strawberry) received the highest score from both groups (Ca 16.0 +/- 3.0 vs Co 17.1 +/- 2.6, N.S.) while Vital received the lowest (Ca 6.3 +/- 4.8 vs Co 4.9 +/- 4.2, NS). Similar results were obtained for breast cancer patients and their controls except that chocolate Sustacal was rated significantly higher by breast cancer patients than by controls (16.6 +/- 2.6 vs 13.3 +/- 4.3, p less than 0.01). Again, Ensure Plus (strawberry) received the highest score from both groups (Ca 17.0 +/- 3.5 vs Co 17.8 +/- 2.3, NS), while Vital was rated lowest by both groups (Ca 5.6 +/- 4.7 vs Co 4.3 +/- 5.0, NS). The modified wine-tasting scale provides a method for quantitating taste preference for various dietary supplements. We report here the numerical rating of 11 supplements by patients with lung cancer and patients with breast cancer as well as their age- and sex-matched controls.
Subject(s)
Food, Formulated , Taste , Breast Neoplasms/therapy , Female , Humans , Lung Neoplasms/therapy , Male , Middle Aged , Smell , WineABSTRACT
In October 1981, an outbreak of 29 cases of community-acquired pneumonia occurred among adult residents of Johnson County, Iowa. Retrospective study revealed 12 cases (41 per cent) had laboratory evidence of Legionnaires' disease (LD). No significant differences in clinical or epidemiological features were found between LD cases and the other pneumonias in the outbreak. All LD cases received erythromycin; one case died for a case-fatality rate of 8 per cent. The outbreak's focus could not be identified.
Subject(s)
Disease Outbreaks/epidemiology , Legionnaires' Disease/epidemiology , Adult , Epidemiologic Methods , Female , Humans , Iowa , Legionella/isolation & purification , Legionnaires' Disease/diagnosis , Lung/microbiology , Male , Pneumonia/diagnosis , Pneumonia/epidemiology , Retrospective StudiesABSTRACT
This study was undertaken to evaluate the sensitivity of the direct immunofluorescence test on Formalin-fixed, trypsin-digested, rabies-infected brain tissue. Our results suggest that the optimal unmasking of rabies antigenic sites is obtained by using a double enzyme digestion with pepsin and trypsin in lieu of only trypsin.
Subject(s)
Brain/pathology , Pepsin A/metabolism , Rabies/pathology , Trypsin/metabolism , Animals , Brain/microbiology , Fluorescent Antibody Technique , Formaldehyde , MiceABSTRACT
We reviewed antibody titers to Mycoplasma pneumoniae and Legionella pneumophila serogroup I in sera from 1,060 cases of acute respiratory infection to determine whether there was an association in seroreactivity to these organisms. Of the 170 serum pairs with antibodies to L. pneumophila (35 seroconversions and 135 with presumptive titers), 32 (18.8%) demonstrated seroreactivity to M. pneumoniae (17 seroconversions and 15 with presumptive titers). This frequency was not significantly greater than the seroreactivity to M. pneumoniae observed in sera without antibodies to L. pneumophila (17.5%) (0.05 less than P less than 0.10), which included 111 seroconversions and 45 sera with presumptive titers.
